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Organization

HARVARD PHYSICAL THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBORAH GULBRANDSON P.T. (OWNER-PRESIDENT)
(847) 516-8095
Entity
Organization

Contact information

Practice address
343 S DIVISION ST, HARVARD, IL 60033-3276
(815) 943-0191
(815) 943-0196
Mailing address
2615 3 OAKS RD, SUITE 1A, CARY, IL 60013-6127
(847) 516-8095
(847) 516-8095

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05632091
BLUE CROSS BLUE SHIELD
IL
01
7153220
AETNA
IL
Enumeration date
02/20/2007
Last updated
07/21/2022
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